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  • 1.
    Gunnarsson, N.
    et al.
    Umeå University, Sweden.
    Höglund, M.
    University of Uppsala Hospital, Sweden.
    Stenke, L.
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Wallberg-Jonsson, S.
    Umeå University, Sweden.
    Sandin, F.
    Regional Cancer Centre, Sweden.
    Björkholm, M.
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Dreimane, Arta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Lambe, M.
    Regional Cancer Centre, Sweden; Karolinska Institute, Sweden.
    Markevarn, B.
    University of Umeå Hospital, Sweden.
    Olsson-Stromberg, U.
    University of Uppsala Hospital, Sweden.
    Wadenvik, H.
    Sahlgrens University Hospital, Sweden.
    Richter, J.
    Skåne University Hospital, Sweden.
    Sjalander, A.
    Umeå University, Sweden.
    Increased prevalence of prior malignancies and autoimmune diseases in patients diagnosed with chronic myeloid leukemia2016Inngår i: Leukemia, ISSN 0887-6924, E-ISSN 1476-5551, Vol. 30, nr 7, s. 1562-1567Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We recently reported an increased incidence of second malignancies in chronic myeloid leukemia (CML) patients treated with tyrosine kinase inhibitors (TKI). To elucidate whether this increase may be linked, not to TKI but rather to a hereditary or acquired susceptibility to develop cancer, we estimated the prevalence of malignancies, autoimmune disease (AD) and chronic inflammatory disease (CID) in CML patients prior to their CML diagnosis. Nationwide population-based registers were used to identify patients diagnosed with CML in Sweden 2002-2012 and to estimate the prevalence of other malignancies, AD and CID prior to their CML diagnosis. For each patient with CML, five matched controls were selected from the general population. Conditional logistic regression was used to calculate odds ratios (OR). Nine hundred and eighty-four CML patients were assessed, representing more than 45 000 person-years of follow-up. Compared with matched controls, the prevalence of prior malignancies and AD was elevated in CML patients: OR 1.47 (95% confidence interval (CI) 1.20-1.82) and 1.55 (95% CI 1.21-1.98), respectively. No associations were detected between CML and previous CID. An increased prevalence of other malignancies and AD prior to the diagnosis of CML suggest that a hereditary or acquired predisposition to cancer and/or autoimmunity is involved in the pathogenesis of CML.

  • 2.
    Gunnarsson, Niklas
    et al.
    Umeå University, Sweden.
    Stenke, Leif
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Hoglund, Martin
    University of Uppsala Hospital, Sweden; University of Uppsala Hospital, Sweden.
    Sandin, Fredrik
    Regional Cancer Centre, Sweden.
    Bjorkholm, Magnus
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Dreimane, Arta
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten.
    Lambe, Mats
    Regional Cancer Centre, Sweden; Karolinska Institute, Sweden.
    Markevarn, Berit
    Umeå University Hospital, Sweden.
    Olsson-Stromberg, Ulla
    University of Uppsala Hospital, Sweden; University of Uppsala Hospital, Sweden.
    Richter, Johan
    Skåne University Hospital, Sweden.
    Wadenvik, Hans
    Sahlgrens University Hospital, Sweden.
    Wallvik, Jonas
    Umeå University, Sweden.
    Sjalander, Anders
    Umeå University, Sweden.
    Second malignancies following treatment of chronic myeloid leukaemia in the tyrosine kinase inhibitor era2015Inngår i: British Journal of Haematology, ISSN 0007-1048, E-ISSN 1365-2141, Vol. 169, nr 5, s. 683-688Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Given that tyrosine kinase inhibitors (TKIs) have dramatically improved the survival of patients with chronic myeloid leukaemia (CML), we were interested in examining the possible risk of long-term adverse events, such as the emergence of other neoplasms. Therefore, we studied the development of second malignancies in 868 patients diagnosed with CML between 2002 and 2011 using the Swedish CML register, cross-linked to the Swedish Cancer register. With a median follow-up of 37 (range 0-99)years, 65 (75%) patients developed 75 second malignancies (non-haematological), 52 of which were of the invasive type. Compared to expected rates in the background population, the risk of second malignancies was higher in the CML cohort, with a standardized incidence ratio (SIR) of 152 (95% CI 113-199). The SIR before and after the second year following diagnosis of CML was 158 and 147, respectively. Among specific cancer types, gastrointestinal and nose and throat cancer were significantly increased. Founded on a population-based material, our results indicate that CML patients treated in the TKI era are at an increased risk of developing a second malignancy, with indications that this risk may more likely be linked to CML itself rather than to the TKI treatment.

  • 3.
    Hjorth-Hansen, Henrik
    et al.
    St Olavs Hospital, Norway; Norwegian University of Science and Technology NTNU, Norway.
    Stenke, Leif
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Söderlund, Stina
    University of Uppsala Hospital, Sweden.
    Dreimane, Arta
    Linköpings universitet, Institutionen för medicin och hälsa. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US. Linköpings universitet, Medicinska fakulteten.
    Ehrencrona, Hans
    Skåne University Hospital, Sweden.
    Gedde-Dahl, Tobias
    University of Oslo, Norway.
    Tore Gjertsen, Bjorn
    Haukeland Hospital, Norway; University of Bergen, Norway.
    Hoglund, Martin
    University of Uppsala Hospital, Sweden.
    Koskenvesa, Perttu
    University of Helsinki, Finland; University of Helsinki, Finland.
    Lotfi, Kourosh
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Diagnostikcentrum, Klinisk farmakologi.
    Majeed, Waleed
    Stavanger University Hospital, Norway.
    Markevarn, Berit
    Umeå University Hospital, Sweden.
    Ohm, Lotta
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Olsson-Stromberg, Ulla
    University of Uppsala Hospital, Sweden.
    Remes, Kari
    Turku University, Finland.
    Suominen, Merja
    Kanta Hame Central Hospital, Finland.
    Simonsson, Bengt
    University of Uppsala Hospital, Sweden.
    Porkka, Kimmo
    University of Helsinki, Finland; University of Helsinki, Finland.
    Mustjoki, Satu
    University of Helsinki, Finland; University of Helsinki, Finland.
    Richter, Johan
    Skåne University Hospital, Sweden.
    Dasatinib induces fast and deep responses in newly diagnosed chronic myeloid leukaemia patients in chronic phase: clinical results from a randomised phase-2 study (NordCML006)2015Inngår i: European Journal of Haematology, ISSN 0902-4441, E-ISSN 1600-0609, Vol. 94, nr 3, s. 243-250Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We randomised 46 newly diagnosed patients with chronic myeloid leukaemia (median age 56) to receive dasatinib 100mg QD or imatinib 400mg QD and report outcome as an intention-to-treat analysis with 36months follow-up. Early cytogenetic and molecular responses were superior in the dasatinib group, with a tendency that imatinib patients caught up with time. For instance, MR3.0 was reached at 3months in 36% vs. 8% (P=0.02), at 12months in 81% vs. 46% (P=0.02) and at 18months in 73% vs. 65% (n.s.) of the patients in the two groups. In contrast, MR4.5 was consistently superior in the dasatinib group at all time points from 6months onwards, reaching 61% vs. 21% (Pless than0.05) at 36months. Sixty-four vs. 71% of the patients in the dasatinib and imatinib arms, respectively, remained on assigned drug. Dasatinib dose was frequently reduced, but with maintained excellent effect. One imatinib patient progressed to blastic phase, but no CML-related deaths occurred. In conclusion, our data compare favourably with those of the dasatinib registration study, DASISION. The fast and deep molecular responses induced by dasatinib compared with imatinib may be exploited to increase the proportion of patients who can achieve a treatment-free remission after treatment discontinuation.

  • 4.
    Hoglund, Martin
    et al.
    University of Uppsala Hospital, Sweden .
    Sandin, Fredrik
    Regional Cancer Centre, Sweden .
    Hellstrom, Karin
    Regional Cancer Centre, Sweden .
    Bjoreman, Mats
    University Hospital, Sweden .
    Bjorkholm, Magnus
    Karolinska University Hospital, Sweden .
    Brune, Mats
    Sahlgrens University Hospital, Sweden .
    Dreimane, Arta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Ekblom, Marja
    Skåne University Hospital, Sweden .
    Lehmann, Soren
    Karolinska University Hospital, Sweden .
    Ljungman, Per
    Karolinska University Hospital, Sweden .
    Malm, Claes
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Onkologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Hematologiska kliniken US.
    Markevarn, Berit
    Umeå University Hospital, Sweden .
    Myhr-Eriksson, Kristina
    Sunderby Luleå Hospital, Sweden .
    Ohm, Lotta
    Karolinska University Hospital, Sweden .
    Olsson-Stromberg, Ulla
    University of Uppsala Hospital, Sweden .
    Sjalander, Anders
    Umeå University, Sweden .
    Wadenvik, Hans
    Sahlgrens University Hospital, Sweden .
    Simonsson, Bengt
    University of Uppsala Hospital, Sweden .
    Stenke, Leif
    Karolinska University Hospital, Sweden .
    Richter, Johan
    Skåne University Hospital, Sweden .
    Tyrosine kinase inhibitor usage, treatment outcome, and prognostic scores in CML: report from the population-based Swedish CML registry2013Inngår i: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 122, nr 7, s. 1284-1292Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Clinical management guidelines on malignant disorders are generally based on data from clinical trials with selected patient cohorts. In Sweden, more than 95% of all patients diagnosed with chronic myeloid leukemia (CML) are reported to the national CML registry, providing unique possibilities to compile population-based information. This report is based on registry data from 2002 to 2010, when a total of 779 patients (425 men, 354 women; median age, 60 years) were diagnosed with CML (93% chronic, 5% accelerated, and 2% blastic phase) corresponding to an annual incidence of 0.9/100 000. In 2002, approximately half of the patients received a tyrosine kinase inhibitor as initial therapy, a proportion that increased to 94% for younger (andlt;70 years) and 79% for older (andgt;80 years) patients during 2007-2009. With a median follow-up of 61 months, the relative survival at 5 years was close to 1.0 for patients younger than 60 years and 0.9 for those aged 60 to 80 years, but only 0.6 for those older than 80 years. At 12 months, 3% had progressed to accelerated or blastic phase. Sokal, but not European Treatment and Outcome Study, high-risk scores were significantly linked to inferior overall and relative survival. Patients living in university vs nonuniversity catchment areas more often received tyrosine kinase inhibitors up front but showed comparable survival.

  • 5.
    Richter, Johan
    et al.
    Skåne University Hospital, Sweden.
    Soderlund, Stina
    University Hospital, Uppsala, Sweden.
    Lubking, Anna
    Skåne University Hospital, Sweden.
    Dreimane, Arta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Lotfi, Kourosh
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Diagnostikcentrum, Klinisk farmakologi.
    Markevarm, Berit
    University Hospital, Umeå, Sweden.
    Sjalander, Anders
    Umeå University, Sweden.
    Saussele, Susanne
    Univ Med Mannheim, Mannheim, Germany.
    Olsson-Stromberg, Ulla
    University Hospital, Uppsala, Sweden.
    Stenke, Leif
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Letter: Musculoskeletal Pain in Patients With Chronic Myeloid Leukemia After Discontinuation of Imatinib: A Tyrosine Kinase Inhibitor Withdrawal Syndrome? in JOURNAL OF CLINICAL ONCOLOGY, vol 32, issue 25, pp 2821-28232014Inngår i: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 32, nr 25, s. 2821-2823Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    n/a

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